Relationship between Altered Platelet Morphological Parameters and Retinopathy in Patients with Type 2 Diabetes Mellitus

Abstract

Purpose. To investigate whether platelet morphology or function is altered in patients with diabetic retinopathy (DR). Methods. This prospective study enrolled 85 healthy controls (HCs) (group 1) and 262 patients with Type 2 diabetes mellitus (T2DM). Patients were subclassified into three groups according to ocular findings: no DR (group 2; n = 88); nonproliferative DR (group 3; n = 88), and proliferative DR (group 4; n = 86). Mean platelet volume (MPV), platelet distribution width (PDW), platelet large cell ratio (PLCR), plateletcrit (PCT) values, and platelet count were measured in the studied groups. Results. MPV, PDW, and PLCR levels were significantly altered in groups 2–4 compared with HCs (p < 0.05, p < 0.05, p < 0.05). Compared with group 2, both DR groups had higher MPV and PDW levels, with a significant difference between groups 2 and 4 for both MPV (p = 0.036) and PDW (p = 0.006). PLCR correlated with retinopathy stage, but no significant difference was found between the DR groups. Platelet count and PCT values were not significantly different between the groups (p > 0.05). Conclusion. Our findings suggest an association between mean platelet indices (MPI) (i.e., MPV, PDW, and PLCR) and DR stage. Therefore, MPI could be a beneficial prognostic marker of DR in patients with T2DM.

The association of neutrophil to lymphocyte ratio, mean platelet volume, and platelet distribution width with diabetic retinopathy and nephropathy: a meta-analysis

“…The number of the included subjects in the case group and the control group ranged from 20 to 328 and 20 to 192, respectively. Of these 48 articles, 27 came from China [ 22 , 30 , 34 , 36 , 37 , 41 , 43–46 , 48 , 49 , 55–60 , 64 , 65 , 67 , 68 , 70–73 ], 16 from Turkey [ 21 , 23 , 29 , 31 , 35 , 38 , 40 , 42 , 47 , 50–54 , 61 , 69 ], 3 from India [ 32 , 63 , 39 ], 1 from Greece [ 62 ] and 1 from Kazakhstan [ 33 ]. Amongst these studies, 21 reported NLR (9 enrolled patients with DR, 12 enrolled patients with DN) [ 21 , 23 , 31 , 32 , 34 , 35 , 38 , 41–43 , 45 , 47 , 50–54 , 56–60 , 62 , 63 , 65 , 67–69 , 71–73 ], 33 reported the data of MPV (23 enrolled patients with DR, 10 enrolled patients with DN) [ 22 , 29 , 30 , 33 , 36–40 , 44 , 46 , 48–50 , 55 , 61 , 64 , 66 , 70 , 73 ], and 12 reported PDW (12 enrolled patients with DR, 3 enrolled patients with DN) […”

A review of relationship between platelet indices and microvascular complications in type 2 diabetic patients

“…31 Yilmaz et al, had found that Mean platelet volume is correlating directly with the stage of diabetic retinopathy. 32 Mean platelet volume is also correlating with diabetic retinopathy, nephropathy and HbA1C levels. 29,33 Mean platelet volume was also found to be related positively with the microalbuminuria and diabetic nephropathy.…”

Platelets: From Formation to Function

“…Some authors suggest that larger platelets are metabolically more active than smaller platelets, that they have faster rates of aggregation and release higher quantities of pro-thrombotic elements such as TxA 2 and ADP [97]. MPV and PDW levels can be altered in several diseases including T2DM [98], CVD and atherosclerosis [93] (Berger et al, 2010), and in this regard they have been suggested as markers of subclinical platelet activation. PLCR and PCT may serve as sensitive biomarkers of platelet health [99].…”